Category Archives: Medications and Adverse Drug Events
Ten Commandments of Geriatric EM Care
Christian Nickel, an Emergency Physician in Basel, Switzerland, has developed 10 commandments (or suggestions) for providing high quality geriatric EM care. This is a dense, high-yield episode in which we cover a wealth of practical tips for improving the care … Continue reading
Hypertensive Emergency Management with Clevidipine
If you haven’t used clevidipine for hypertensive emergencies, you may want to give it a try. It comes as a pre-mixed bottle, has a fast onset (2 minutes), you can titrate up at 90 second intervals, and the terminal … Continue reading
Be ADEPT: An approach to the older patient with confusion or agitation
Older adults often present to the ED for or with confusion or agitation. It is important to have a framework for assessing these patients, diagnosing the presence of delirium or dementia, looking for underlying causes, preventing worsening, treating the underlying … Continue reading
Are Orthostatic Vital Signs Helpful in the ED?
There is some confusion, disagreement, and misunderstanding surrounding orthostatic vitals in the ED. Older patients have a high rate of incidentally-found positive orthostatic vital signs, typically because of heart-rate changes. So emergency physicians may be reluctant to request orthostatics. However, … Continue reading
Subdissociative Dose Ketamine in Older Adults? – Maybe
IV subdissociative dose ketamine (SDK) is used with increasing frequency for acute pain management in the ED. However, most studies have excluded older adults in assessing its efficacy and safety. In this episode, Sergey Motov (@painfreeED) discusses his recent paper “Intravenous … Continue reading
Urinary Infections and Catheters in Older Adults
UTIs, UICs, and CAUTIs in older adults! In this episode, Mary Mulcare, EM and geriatric-EM-trained physician in NYC and I discuss how to diagnose UTIs in older adults, and the confounding factors of asymptomatic bacteriuria, sterile pyuria, and colonization. We … Continue reading
Trauma in Older Adults
Older adults who suffer traumatic injuries have worse outcomes than younger patients. In this episode Dr. Zara Cooper (acute care and trauma surgeon at Brigham and Women’s hospital) and I discuss some of the reasons for this, and also ways … Continue reading
Preventing Falls in the Elderly: An EMS Story
The risk of falls increases as we age. Unfortunately, so does the risk of injury, morbidity, and mortality following a fall. Falls risk is considered a geriatric syndrome, with multi-factorial causes. Falls are a the #1 cause of trauma-related mortality … Continue reading
How to Reverse Oral Anticoagulants
The number of new oral anticoagulants has grown dramatically in the last few years. And with that growth has come the need for new reversal agents. Reversing anticoagulation in patients with acute intra-cranial hemorrhages can be complex and dependent on … Continue reading
Pearls and Pitfalls of Pain Management in Older Adults
Pain is the number one reason why people seek care in the Emergency Department (ED). One major goal of acute care is diagnosing the cause of the pain, but another is helping relieve the suffering associated with pain. In older … Continue reading
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